Control of acute phase intestinal bleeding after percutaneous coronary intervention by discontinuing dual antiplatelet therapy and implementing intra-aortic balloon pumping

Aspirin's efficacy for the prevention of secondary vascular disease is well supported. However, more attention should be given to its side effects, especially gastrointestinal injury. A 62-year-old man suffered acute myocardial infarction of the left main trunk. Although a percutaneous coronary intervention, using a bare metal stent, was successful, intractable in-bowel bleeding developed. To control the bleeding, we discontinued dual antiplatelet therapy during the acute phase, and used intra-aortic balloon pumping to provide sufficient coronary flow to prevent stent thrombosis. This strategy controlled intestinal bleeding without any thrombotic complications, indicating that intra-aortic balloon pumping is effective for preventing stent thrombosis.